There’s no question about it. One of the unspoken fears most women have about vaginal birth is about how it will affect them physically and sexually afterwards.
After all, birth involves the area of the body that we usually associate with pleasure and intimacy.
Naturally, like many women, you might be concerned about how your vagina will recover after having a baby pass through it, and how this might affect your sex life.
Women’s health specialists advocate pelvic floor muscle exercises to help you recover after childbirth. But what happens if you tear, or have an episiotomy?
The Husband Stitch – Myth or Fact?
Enter the whispers about ‘the husband stitch’. It’s widely touted as a myth, but a quick search online unearths countless stories of women who have been given the stitch, while the doctor throws a cheeky wink to the husband.
Even today, women report experiencing something very like the husband stitch. Whether it’s done intentionally or as the result of medical incompetence is much harder to work out.
What Is The Husband Stitch?
Sometimes called the ‘husband’s knot' or a vaginal tuck, the husband stitch has reportedly been around since the 1950s. Doctors would put in the stitch when they were repairing vaginal and perineum tears or episiotomies after birth.
Supposedly, the purpose of the husband stitch was to enhance sexual pleasure for the woman’s partner during sex.
But is it myth, or result of medical evolution? It's difficult to find any mention of this procedure in official quarters but there are countless anecdotes from women who have been subjected to this practice.
It is well known today that tightening the vaginal opening, the introitus, has very little to do with sexual pleasure, which depends more on pelvic floor muscles.
During birth, the internal part of the vagina stretches to accommodate the baby’s head, and doesn’t usually return to its pre-birth shape. With careful attention to pelvic floor muscle tone, however, this change rarely interferes with sex.
How Did We Get To This?
In the 18th century, an Irish surgeon put forward a theory: during birth it was better to cut a woman than to allow the vagina and perineum to tear naturally.
For almost 200 years, episiotomies were rarely used, except when labour was extremely prolonged and there was danger to both mother and baby.
In 1920, an American obstetrician, Joseph DeLee, likened labour to falling on a pitchfork and recommended episiotomy as a preventative procedure to avoid perineal tearing, blood loss, and head trauma for the newborn. He claimed an added benefit was restoring the vagina to its “virginal condition”.
This was, of course, during the time when birth had been transferred from home to hospital and was under the auspices of doctors.
‘Twilight Sleep’ births were also in vogue, which meant women had massive episiotomies and forceps births, because they had been being completely knocked out by anaesthetics.
In the following decades, women were no longer given heavy anaesthesia during labour. Instead, they would give birth while strapped into stirrups, unable to move freely.
By 1980, almost 65% of vaginal births in the US involved episiotomies.
It’s not hard to conclude that during this time significant numbers of women were subjected to having the husband stitch, while an episiotomy or vaginal tear was being repaired.
Often women had no idea what their doctor had done; their husbands were given a wink and a nod. It is difficult to imagine how many women suffered in silence from the side effects.
What Are The Side Effects Of The Husband Stitch?
Today’s medical professionals insist the husband stitch is an urban myth, and no longer part of a doctor’s repertoire.
Even if that is true, many women still experience perineal repairs, which amounts to the same thing.
A quick Internet search digs up many stories of women who had poorly repaired tears or episiotomies after birth, and experienced ongoing pain and problems as a result.
These are the more common side effects of having your vaginal opening stitched more tightly than it was before giving birth:
- Being unable to walk, for a longer period than is normal after the birth
- Feeling pain when standing up straight
- Painful sex, making women fear or avoid having sex
- Chronic pain and swelling
- Ongoing infections
- Reopening of the scar tissue
- Emotional trauma
What was a possibly deliberate and invasive procedure has now become myth, but it doesn’t necessarily mean the procedure isn’t performed – either with or without a woman’s consent. The difficulty lies in knowing whether it has happened or whether any problems are simply associated with perineal tearing or trauma.
Women who have ongoing problems might assume they have been given a husband stitch when it’s just as likely they have had an unnecessarily large episiotomy which hasn’t been repaired well.
Regardless of whether the intentional husband stitch is a thing of the past, care providers involved in repairing vaginal and perineal tears should be experienced enough to avoid creating more problems for women.
When you choose a care provider, find one who doesn’t perform routine episiotomies.
There are ways to avoid any major tearing – including perineal support, active birth positions, and labouring in water. Discuss your options, and ask care providers about their experience in repairing vaginal tears.
Choose someone who has plenty of experience and current knowledge.